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66.2 per cent. in the four years 1890-93 to 30.7 per cent. in 1909, from which
we may inter that if no antitoxin had been administered, the deaths in 1909,
instead of being 110, the actual number, would have been 248. We may take
it, therefore, that there has been a saving of 138 lives. Vide Chart C.
Last year (1909) Professor Kroenlein, Professor of Surgery at the
University of Zurich, requested his senior Surgeon, Dr. Ph. Schoenhozer, to
examine the records and report on the cases of Diphtheria treated at his
clinique during a period of twenty-eight years. As in 14 of these years the
old methods had been practised and in 14 the modern antitoxin treatment,
a comparison of therapeutic results is possible. In the pre-antitoxin period
(1881-1894) it was found that out of 1,336 patients, 534, or 40 per cent.,
succumbed to the disease, whereas in the antitoxin period, out of 1,986 patients
registered from 1884 to 1906, only 266, or 13.4 per cent. died.
Of the tracheotomy cases 66 per cent. died in the pre-antitoxin period,
and only 14 per cent. died under the antitoxin regime.*
Doctors Mackay and O'Brien have reported that in 1908, at the Fairheld
Infectious Diseases Hospital, Melbourne,† to which they were attached,
the.e were only 23 deaths among 404 patients treated with anti-toxin, or a
fatality of 5'7 per cent.; or excluding patients dying within 24 hours of
admission, only 16 deaths, or a fatality of 4 per cent. They also state that at
the Coast Hospital, Sydney, in 1907, there were only 23 deaths among 350
cases, or a fatality of 6.6 per cent.; and that in Perth Public Hospital in the
same year there were only 18 deaths among 249 cases, or a fatality of 7.6 per cent.
These figures are very forcibly supported by the results obtained in the
Metropolitan Asylums Board Hospitals.
It would be interesting, if the figures were available, but they are not, to
analyse the results of the antitoxin treatment of Islington patients. Fortunately,
however, the number of notifications and deaths are, and they are
set out in Appendix A. The figures show that in the three pre-antitoxin
years, 1891-93, there were 2,379 separate cases notified, of which 548, or 23.0
died, whereas in the succeeding seven years (1894-1900) there were 5,151
cases, of which 1,077 died or 20.9 per cent. During this period the fatality
ranged from 25T per cent. to 16.7 per cent., and it is a noticeable fact
that in each successive year the percentage of deaths decreased. In the
following nine "years 1901-1909, when antitoxin treatment was much more
fully adopted, there were 4,822 cases and 508 deaths, or 10'5 per cent.; while
the fatality ranged from 14.7 per cent. in 1901 to 7.2 per cent in 1909. When
all the figures I have quoted are taken collectively, it cannot be doubted that
a very strong case is made out for the antitoxin treatment.
There is another factor in the antitoxin treatment which is of the very
greatest importance, namely, that the earlier the treatment is adopted the more
certain is the cure of the patient.
* Lancet, May 15th, 1909.
† lntercolonial Medical Journal of Australasia, February 20th, 1909.